Infant Data
Postmenstrual Age(PMA) = gestational age plus postnatal age.
Results
INDICATIONS
- Treatment of infections caused by aerobic gram-negative bacilli (e.g. Pseudomonas, Klebsiella, E coli). Usually used in combination with a β-lactam antibiotic.
ADVERSE EFFECTS
Transient and reversible renal tubular dysfunction may occur, resulting in increased urinary losses of sodium, calcium, and magnesium. Vestibular and auditory ototoxicity. The addition of other nephrotoxic and/or ototoxic medications (e.g. furosemide, vancomycin) may increase these adverse effects. Increased neuromuscular blockade (i.e. neuromuscular weakness and respiratory failure) may occur when used with pancuronium or other neuromuscular blocking agents and in patients with hypermagnesemia.
ADMINISTRATION
Give as an IV infusion by syringe pump over 30 minutes. Administer as a separate infusionfrom penicillin-containing compounds. IM injection is associated with variable absorption, especially in the very small infant.
MONITORING
Measure serum concentrations when treating for more than 48 hours. Obtain peak concentration 30 minutes after end of infusion, and trough concentration just prior to the next dose. When treating patients with serious infections or significantly changing fluid or renal status consider measuring the serum concentration 24 hours after a dose, and use the chart below for the suggested dosing interval. Blood samples obtained to monitor serum drug concentrations should be spun and refrigerated or frozen as soon as possible.
Therapeutic serum concentrations: Peak: 5 to 12 mcg/mL (or Cmax /MIC ratio greater than 8:1) Trough: 0.5 to 1 mcg/mL